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Friday, July 8, 2016

Candida is Cropping Up in Countless Countries

I can’t say for certain that the reason we’re hearing
concerns over new pathogens is from the fact that they are newly rearing their
heads or if because we are further ahead in our surveillance measures so finding
them faster. I’d like to think it’s the
latter.

In the last 3 of 4 weeks I have blogged about new bugs of
concern (“Has
the sky fallen with mcr-1”) or a known bug causing problems in an unknown
way (“Does
your PICU have Burkholderia?”). This
week being the 3rd with the announcement that a new species of Candida is emerging as a fungal (yeast)
organism associated with invasive infections.

According
to the CDC, Candida auris has
made its way to the Americas after it was found in a Venezuelan hospital. It has been linked to invasive infections in
the critically ill and other immunocompromised patients who are subject to
broad-spectrum antibiotics and invasive procedures. Candida
auris was first described in 2009 in Japan and since then has also been
found in India, Korea, South Africa, Pakistan, Columbia, the
United Kingdom and Kuwait. The CDC has
found that isolates within each region are quite similar, but are relatively
different across regions. These differences suggest that C. auris has
emerged independently in multiple regions at roughly the same time. From an infection perspective C. auris is
known to cause bloodstream infections, wound infections, and ear infections. It
also has been isolated from respiratory and urine specimens, but it is unclear
if it causes infections in the lung or bladder.

The outbreak in Venezuela included 18 critically ill
patients (mostly neonates) with 5 of the 18 patients dying. Researchers and Infection Preventionists are
warning others that C. auris needs to
be considered as an emergent multidrug-resistant species, which can be a source
of HAIs, which has a high potential for horizontal transmission and is
difficult to eradicate from the hospital environment.

While it’s early on in our understanding of Candida auris, there is some
anecdotal evidence to suggest that this yeast may be able to persist for
extended periods of time in the environment, making effective cleaning and
disinfection using an EPA or Health Canada registered disinfectant with a
Fungicidal claim for both daily and terminal cleaning important and a key to
minimizing further transmission.

Here’s hoping that next week I don’t have to report on yet
another new bug!